An Act to further define medical necessity determinations
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Overview
This bill clarifies the definitions of several mental health terms used in Massachusetts healthcare, including ‘mental health acute treatment,’ ‘mental health crisis stabilization services,’ ‘community-based acute treatment,’ and ‘intensive community-based acute treatment.’ It mandates that the state’s group insurance commission cover these services for state employees and retirees without requiring prior authorization, and extends coverage to Medicaid recipients and individuals with private health insurance plans. The bill also outlines procedures for notification and treatment planning at facilities providing these services.
Key provisions
- Defines ‘mental health acute treatment’ as 24-hour medically supervised mental health services in an inpatient facility.
- Defines ‘mental health crisis stabilization services’ as 24-hour clinically managed services for adults or adolescents.
- Defines ‘community-based acute treatment (CBAT)’ as 24-hour clinically managed services for children and adolescents.
- Defines ‘intensive community-based acute treatment (ICBAT)’ as intensive 24-hour clinically managed services for children and adolescents.
- Requires the state’s group insurance commission to cover medically necessary mental health acute treatment, crisis stabilization services, CBAT, and ICBAT for state employees and retirees without prior authorization.
- Requires Medicaid managed care organizations and primary care clinicians to cover medically necessary mental health acute treatment, crisis stabilization services, CBAT, and ICBAT.
Bill text
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Sponsors
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3 on record
Primary sponsor
Joint Committee on Financial Services
Cosponsors
Michael P. Kushmerek
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